Papillensklerose

Secretin-stimulated

MR cholangiopancreatography: spectrum of findings in pancreatic diseases. a–c Inflammatory ampullary stenosis. MRCP obtained before secretin administration (a) reveals distal common bile duct stenosis, with consequent dilatation of extra-hepatic bile ducts. The head portion of pancreatic duct is only slightly dilated. MRCP obtained 3 min after secretin injection (b) shows increasing diameter of the pancreatic duct and after 15 min (c) demonstrates duodenal filling up to genu inferius (grade 2), interpreted as reduced exocrine pancreatic reserve. Endoscopic evaluation with papillary biopsy confirmed the diagnosis